Nail psoriasis occurs in many people with psoriasis in addition to the psoriasis typical skin lesions. The nails will show different stain patterns or lose their strength. In most cases, psoriasis is not only produced on a single nail, but also on several at the same time – often on the fingers as well as on the toes. Learn more about nail psoriasis here.
Nail psoriasis: frequency
There is a strong connection between psoriatic arthritis (a form of joint inflammation) and nail psoriasis: nearly three quarters of all psoriatic arthritis sufferers from nail psoriasis. For comparison: In skin psoriasis, the proportion is about fifty percent. The specific changes on the nails can be differentiated from each other:
Psoriasis, nail changes: spotted nails
As Tüpfelnägel nails are referred to, which have several pinhead-sized indentations as a result of psoriasis. On an infected nail are usually several such indentations.
Psoriasis, nail changes: Psoriatic oil stain
In this form of nail change, the nail bed inflames as a result of psoriasis. As a result, more scales form under the nail plate. One speaks of an “oil stain” because the nails turn yellowish at the corresponding points. In some cases, the nail plate is detached from the nail bed by the pathological changes.
Psoriasis, nail changes: crumb nails
As crumb nails doctors refer to nails in which the nail plate is severely damaged by psoriasis. The nail is crumbly and yellowish discolored, sometimes the nail plate is not complete in all places. In some cases, it is also thickened or splintered.
Psoriasis, nail changes: dandruff under the nail
Similarly, psoriasis of the nails may cause increased scaling under the nail plate. Often the nail plate is detached from the nail bed by the strong dandruff.
The described typical nail changes do not necessarily occur individually, but can also occur simultaneously on one or more nails. They often lead to pain when walking and grasping – and thus hamper patients with many everyday activities, whether at home or at work.
“Psoriasis nails” – especially affected fingernails – are often very distressing for those affected because many people associate broken and / or discolored fingernails with a lack of personal hygiene. This is why many people try to hide psoriasis, fingernails and hands as much as possible with these symptoms. Partly they gradually withdraw from their social contacts, as their nails are unpleasant to them. Among other things, it is therefore important to have a nail psoriasis treated as soon as possible after its occurrence.
The nail psoriasis and psoriatic arthritis are closely related: Not only do significantly more people with psoriatic arthritis have nail psoriasis; The severity of an existing nail psoriasis is also related to the severity of any psoriatic arthritis that may follow. As a rule, nails change during psoriasis before signs of psoriatic arthritis appear. For this reason, nail psoriasis may also be a good “harbinger” for psoriatic arthritis.
Diagnosis of nail psoriasis
The doctor sometimes recognizes nail psoriasis at first glance – especially if a patient is already being treated for psoriasis. It becomes more difficult when a nail psoriasis occurs before skin symptoms are visible. Then it may be more expensive to delineate a psoriasis of the nails against fungal diseases, eczema or other diseases. In some cases, the doctor will have a sample of the nail (biopsy) examined in the laboratory to confirm the diagnosis.
Therapy of nail psoriasis
Rapid treatment of nail psoriasis prevents the condition of the nails from further deteriorating. Physicians also suspect that early treatment can help to alleviate any subsequent psoriatic arthritis.
As a rule, pot nails and oil stains are not treated medically, as they do not have a high disease value. Visually disturbing areas can cover patients themselves with a nail polish.
When the nail plate becomes detached due to nail psoriasis or its texture changes, various preparations for application to the nail are available. These contain either cortisone or cortisone plus calcipotriol (vitamin D3 derivative). If severe nail psoriasis is present, the doctor may prescribe additional medication approved for the treatment of psoriasis. Which these are, the doctor decides in each case. The treatment often extends over several months.
Since nails grow back slowly, sufferers have to be patient until they can see the success of the treatment – that is, regrown, neat nails. Often, however, it is not possible nail psoriasis completely disappear.